Active NPI
Patricia Ann Gaines, RD, LDN
- Registered Dietitian
- Skokie, IL
National Provider Identifier
1154623742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 164.001196
- Practice address
- 9600 Gross Point Road.
Skokie, IL 60016-1752 - Phone
- (847) 933-6802
- Fax
- (847) 933-6807
- NPI assigned
- Dec 2, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 164.001196 | IL | Primary |
Addresses
Primary practice location
9600 Gross Point Road.
Skokie, IL 60016-1752
Mailing address
9600 Gross Point Road.
Skokie, IL 60016-1752
Phone (847) 933-6802
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| L98390 | Other | IL | MEDICARE PART B |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 164.001196 | IL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1291248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1291248000000",
"number": "1154623742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9600 GROSS POINT ROAD.",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600161752",
"telephone_number": "847-933-6802",
"fax_number": "847-933-6807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9600 GROSS POINT ROAD.",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600161752",
"telephone_number": "847-933-6802",
"fax_number": "847-933-6807"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAINES",
"first_name": "PATRICIA",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "RD, LDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-12-02",
"last_updated": "2010-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IL",
"license": "164.001196",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PART B",
"identifier": "L98390",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.